Andrew J Theiss, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00005436 Issued in FL

Practice address

4501 Tamiami TRL N
Suite 318
Naples, FL 34103-3060

Phone

(239) 649-7799

Fax

(239) 566-1844

NPI assigned

Jul 30, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185753600000",
    "number": "1932399656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 TAMIAMI TRL N",
            "address_2": "SUITE 318",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033060",
            "telephone_number": "239-649-7799",
            "fax_number": "239-566-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 TAMIAMI TRL N",
            "address_2": "SUITE 318",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033060",
            "telephone_number": "239-649-7799",
            "fax_number": "239-566-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISS",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY00005436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Naples, FL
• Providers in Naples, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.